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Pasokh Z, Seif M, Ghaem H, Rezaianzadeh A, Ghoddusi Johari M. Age at natural menopause and its determinants in female population of Kharameh cohort study: Comparison of regression, conditional tree and forests. PLoS One 2024; 19:e0300448. [PMID: 38625988 PMCID: PMC11020934 DOI: 10.1371/journal.pone.0300448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/28/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Natural menopause is defined as the permanent cessation of menstruation that occurs after 12 consecutive months of amenorrhea without any obvious pathological or physiological cause. The age of this phenomenon has been reported to be associated with several health outcomes. OBJECTIVES This study aimed to estimate the Age at Natural Menopause (ANM) and to identify reproductive and demographic factors affecting ANM. METHODS This cross-sectional, population-based study was conducted on 2517 post-menopausal women aged 40-70 years participating in the first phase of the PERSIAN cohort study of Kharameh, Iran, during 2014-2017. To more accurately detect the determinants of ANM, we applied multiple linear regression beside some machine learning algorithms including conditional tree, conditional forest, and random forest. Then, the fitness of these methods was compared using Mean Squared Error (MSE) and Pearson correlation coefficient. RESULTS The mean±SD of ANM was 48.95±6.13. Both applied forests provided more accurate results and identified more predictors. However, according to the final comparison, the conditional forest was the most accurate method which recognized that more pregnancies, longer breastfeeding, Fars ethnicity, and urbanization have the greatest impact on later ANM. CONCLUSIONS This study found a wide range of reproductive and demographic factors affecting ANM. Considering our findings in decision-making can reduce the complications related to this phenomenon and, consequently, improve the quality of life of post-menopausal women.
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Affiliation(s)
- Zahra Pasokh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kutenaee MA, Dashti S, Rafati S, Moannaei M, Masoudi M, Nejatizadeh A, Shahmoradi M, Roozbeh N. Factors predicting age at menopause among Iranian women in the Bandare-Kong cohort study (a cross-sectional survey of PERSIAN cohort study). Womens Midlife Health 2023; 9:5. [PMID: 37641084 PMCID: PMC10463461 DOI: 10.1186/s40695-023-00088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Menopause is a natural period in women's life and can be affected by several factors. The aim of this study was to identify the associated factors for age of natural menopause and among women with early and premature menopause based on a cohort study in Iran. METHODS This population-based study was conducted on 894 post menopause women between 35 and 70 years old who participated in the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in Iran (PERSIAN) from March 2016 to February 2019. All women completed a standard self-reported questionnaire. Data were analyzed using chi-square test, independent t test, and ANOVA as well as a multivariable linear regression model. RESULTS The mean age at natural menopause was 48.31 ± 6.34 years. After adjusting other variables, gravida, history of cardiac disease, socioeconomic status and residence status were predictive of age at menopause (P < 0.001). Among the premature menopause group, the mean age at menopause was significantly higher among women with diabetes compared to women without diabetes group (35.68 ± 2.92 vs. 33.82 ± 3.06; P = 0.043), while the mean age at menopause was significantly lower in women with infertility compared to women without infertility (29.13 ± 5.22 vs. 34.84 ± 2.826; P = 0.048). CONCLUSIONS This study suggests that the predictors of menopausal age differed in women with premature menopause compared to overall menopause age. Prospective studies are needed to evaluation the effects of these factors on menopausal age.
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Affiliation(s)
- Maryam Azizi Kutenaee
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sareh Dashti
- Department of Public Health, Faculty of Paramedicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | - Shideh Rafati
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehrsa Moannaei
- Department of Gynecology and Obstetrics, School of Medicine, Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mojtaba Masoudi
- Fatemiyeh Shiraz Institute of Higher Education, Shiraz, Iran
| | - Abdolazim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Shahmoradi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Chikwati RP, Mahyoodeen NG, Jaff NG, Ramsay M, Micklesfield LK, Wade AN, Agongo G, Asiki G, Choma SSR, Boua PR, George JA, Crowther NJ. Cardiometabolic disease risk factors in pre- and postmenopausal women from four sub-Saharan African countries: A cross-sectional study. Maturitas 2023; 172:60-68. [PMID: 37116348 PMCID: PMC10278059 DOI: 10.1016/j.maturitas.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/17/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To compare the risk factors for cardiometabolic disease between pre- and postmenopausal women from four sub-Saharan African countries. STUDY DESIGN This cross-sectional study included 3609 women (1740 premenopausal and 1869 postmenopausal) from sites in Ghana (Navrongo), Burkina Faso (Nanoro), Kenya (Nairobi), and South Africa (Soweto and Dikgale). Demographic, anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women, within and across sites using multivariable regression analyses. The sites represent populations at different stages of the health transition, with those in Ghana and Burkina Faso being rural, whilst those in Kenya and South Africa are more urbanised. MAIN OUTCOME MEASURES Anthropometric and cardiometabolic variables. RESULTS The prevalence rates of risk factors for cardiometabolic disease were higher in South (Soweto and Dikgale) and East (Nairobi) Africa than in West Africa (Nanoro and Navrongo), irrespective of menopausal status. Regression models in combined West African populations demonstrated that postmenopausal women had a larger waist circumference (β = 1.28 (95 % CI: 0.58; 1.98) cm), log subcutaneous fat (β =0.15 (0.10; 0.19)), diastolic (β = 3.04 (1.47; 4.62) mm Hg) and log systolic (β = 0.04 (0.02; 0.06)) blood pressure, log carotid intima media thickness (β = 0.03 (0.01; 0.06)), low-density lipoprotein cholesterol (β = 0.14 (0.04; 0.23) mmol/L) and log triglyceride (β= 0.10 (0.04; 0.16)) levels than premenopausal women. No such differences were observed in the South and East African women. CONCLUSIONS Menopause-related differences in risk factors for cardiometabolic disease were prominent in West but not East or South African study sites. These novel findings should inform cardiometabolic disease prevention strategies in midlife women specific to rural and urban and peri-urban locations in sub-Saharan Africa.
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Affiliation(s)
- Raylton P Chikwati
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nasrin Goolam Mahyoodeen
- Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole G Jaff
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa K Micklesfield
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alisha N Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Godfred Agongo
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Department of Biochemistry and Forensic Science, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Science, Navrongo, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Solomon S R Choma
- Department of Pathology and Medical Sciences, DIMAMO HDSS, University of Limpopo, Polokwane, South Africa
| | - Palwende R Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Burkina Faso
| | - Jaya A George
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
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An J, Li L. Urban-rural differences in epidemiology and risk factors of menopause syndrome in middle-aged Chinese women. Menopause 2023; 30:306-316. [PMID: 36728551 DOI: 10.1097/gme.0000000000002135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare the prevalence and severity of menopausal symptoms and investigate their associated factors among rural and urban middle-aged Chinese women. METHODS A descriptive, cross-sectional study of 4,580 urban and 2,729 rural randomly sampled participants aged 40 to 55 years in Gansu Province, China, was conducted. Questionnaires assessing the sociodemographic information and menstrual and reproductive histories of the participants were administered. The modified Kupperman scale was used to assess the presence and severity of menopausal symptoms. Binary and ordinal logistic regression analyses were performed to identify factors associated with the occurrence and severity of menopausal syndrome, respectively, according to the modified Kupperman Menopausal Index score rank. RESULTS The natural menopausal age of the rural women was significantly lower than that of the urban women (rural: 47.22, urban: 47.98; P < 0.05). Furthermore, rural women had a higher prevalence (rural: 56.35%, urban: 43.47%) and severity (rural: 11.40%, urban: 6.61%) of menopausal syndrome than the urban women ( P < 0.05). For both the urban and rural women, the prevalence and severity of most menopausal symptoms increased as menopause progressed. The three most prevalent symptoms in both the urban and rural women were fatigue (rural: 70.43%, urban: 68.19%), muscle/joint pain (rural: 62.84%, urban: 59.32%), and vertigo (rural: 57.42%, urban: 47.44%). Positive associations between menopausal symptoms and age, residence, body mass index, level of education, time of pregnancy, menstrual cycle, and presence of chronic diseases were observed. CONCLUSIONS Rural women experience more frequent and severe menopausal syndrome than do urban women.
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Affiliation(s)
- Junxia An
- From the College of Life Sciences, Northwest Normal University, Anning, Lanzhou, Gansu, People's Republic of China
| | - Lifei Li
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Chengguan, Lanzhou, Gansu, People's Republic of China
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Sievert LL, Huicochea-Gómez L, Cahuich-Campos D, Kent JA, Brown DE. Hand grip strength, standing balance, and rapid foot tapping in relation to the menopausal transition in Campeche, Mexico. Am J Hum Biol 2022; 34:e23781. [PMID: 35866928 DOI: 10.1002/ajhb.23781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/08/2022] [Accepted: 07/01/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This cross-sectional study investigated menopause status in relation to hand grip strength, standing balance, and rapid foot tapping. A secondary aim was to examine the relationship between physical performance and urban/rural residence with a focus on habitual daily tasks. METHODS Maya and non-Maya women (40-60 years) were drawn from urban and rural sites in Campeche, Mexico (n = 543). Demographic, reproductive, and lifestyle information was collected in face-to-face interviews along with anthropometric and physical function measures. Linear regression was used to evaluate menopause status in relation to strength, balance, and foot tapping speed while adjusting for residence, ethnicity, and other variables. RESULTS Hand grip strength was 22.5, 21.6, and 20.0 kg in pre-, peri-, and postmenopausal women, respectively, but menopause status was not significantly related to grip strength in models adjusted for age. Grip strength was negatively associated with age and socioeconomic index, and positively associated with height and weight, self-reported health, and hours/week spent grinding corn/making tortillas. Postural stability was 9.4, 6.9, and 5.6 s across menopause categories; and menopause status remained significant in adjusted models. The number of foot taps in 10 s was 35.7, 33.4, and 33.9 taps in pre-, peri-, and postmenopausal women. Parity was negatively associated with foot tapping in adjusted models. CONCLUSIONS While age is a key predictor of physical function in women aged 40-60 years, menopausal status appears to have additional influences on postural control beyond age alone. Hours spent grinding corn/making tortillas were significantly associated with grip strength among rural women.
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Affiliation(s)
| | | | | | - Jane A Kent
- Department of Kinesiology, UMass Amherst, Amherst, Massachusetts, USA
| | - Daniel E Brown
- Department of Anthropology, University of Hawaii, Honolulu, Hawaii, USA
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